|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
IP
|
$508.61
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$353.99 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: BCBS Trust/PPO |
$420.06
|
| Rate for Payer: BCN Commercial |
$420.06
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$417.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$442.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.58
|
| Rate for Payer: UHC Core |
$424.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$199.91 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$237.21
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.76
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$71.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.12
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$71.81
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$50.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Senior Care Partners |
$68.21
|
| Rate for Payer: PACE SWMI |
$71.81
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$71.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Medicare |
$72.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: UHC Exchange |
$71.81
|
| Rate for Payer: UHC Medicaid |
$50.64
|
| Rate for Payer: UHC Medicare Advantage |
$71.81
|
| Rate for Payer: UHCCP Medicaid |
$50.64
|
| Rate for Payer: VA VA |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.70 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna Medicare |
$82.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.73
|
| Rate for Payer: BCBS Complete |
$58.48
|
| Rate for Payer: BCBS MAPPO |
$78.99
|
| Rate for Payer: BCBS Trust/PPO |
$259.74
|
| Rate for Payer: BCN Commercial |
$259.74
|
| Rate for Payer: BCN Medicare Advantage |
$78.99
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.99
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Mclaren Medicaid |
$55.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.94
|
| Rate for Payer: Meridian Medicaid |
$58.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Senior Care Partners |
$75.04
|
| Rate for Payer: PACE SWMI |
$78.99
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: PHP Medicare Advantage |
$78.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.88
|
| Rate for Payer: Priority Health Medicare |
$79.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.90
|
| Rate for Payer: Railroad Medicare Medicare |
$78.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.04
|
| Rate for Payer: UHC Core |
$263.82
|
| Rate for Payer: UHC Exchange |
$78.99
|
| Rate for Payer: UHC Medicaid |
$55.70
|
| Rate for Payer: UHC Medicare Advantage |
$78.99
|
| Rate for Payer: UHCCP Medicaid |
$55.70
|
| Rate for Payer: VA VA |
$78.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.90 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: BCBS Trust/PPO |
$260.94
|
| Rate for Payer: BCN Commercial |
$260.94
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.04
|
| Rate for Payer: UHC Core |
$263.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
IP
|
$917.52
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$638.59 |
| Max. Negotiated Rate |
$825.77 |
| Rate for Payer: Aetna Commercial |
$779.89
|
| Rate for Payer: BCBS Trust/PPO |
$757.78
|
| Rate for Payer: BCN Commercial |
$757.78
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cofinity Commercial |
$789.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.02
|
| Rate for Payer: Healthscope Commercial |
$825.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$688.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$779.89
|
| Rate for Payer: Nomi Health Commercial |
$752.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.14
|
| Rate for Payer: PHP Commercial |
$779.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$798.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$638.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$807.42
|
| Rate for Payer: UHC Core |
$766.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$688.14
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
OP
|
$917.52
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$161.76 |
| Max. Negotiated Rate |
$825.77 |
| Rate for Payer: Aetna Commercial |
$779.89
|
| Rate for Payer: Aetna Medicare |
$238.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$286.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$286.73
|
| Rate for Payer: BCBS Complete |
$169.83
|
| Rate for Payer: BCBS MAPPO |
$229.38
|
| Rate for Payer: BCBS Trust/PPO |
$754.29
|
| Rate for Payer: BCN Commercial |
$754.29
|
| Rate for Payer: BCN Medicare Advantage |
$229.38
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cofinity Commercial |
$789.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.38
|
| Rate for Payer: Healthscope Commercial |
$825.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$688.14
|
| Rate for Payer: Mclaren Medicaid |
$161.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.85
|
| Rate for Payer: Meridian Medicaid |
$169.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$263.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$252.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$779.89
|
| Rate for Payer: Nomi Health Commercial |
$752.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.14
|
| Rate for Payer: PACE Senior Care Partners |
$217.91
|
| Rate for Payer: PACE SWMI |
$229.38
|
| Rate for Payer: PHP Commercial |
$779.89
|
| Rate for Payer: PHP Medicare Advantage |
$229.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$161.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$798.24
|
| Rate for Payer: Priority Health Medicare |
$231.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$638.59
|
| Rate for Payer: Railroad Medicare Medicare |
$229.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$807.42
|
| Rate for Payer: UHC Core |
$766.13
|
| Rate for Payer: UHC Exchange |
$229.38
|
| Rate for Payer: UHC Medicaid |
$161.76
|
| Rate for Payer: UHC Medicare Advantage |
$229.38
|
| Rate for Payer: UHCCP Medicaid |
$161.76
|
| Rate for Payer: VA VA |
$229.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$688.14
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$2,249.92
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,565.94 |
| Max. Negotiated Rate |
$2,024.93 |
| Rate for Payer: Aetna Commercial |
$1,912.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,858.21
|
| Rate for Payer: BCN Commercial |
$1,858.21
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cofinity Commercial |
$1,934.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.94
|
| Rate for Payer: Healthscope Commercial |
$2,024.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.43
|
| Rate for Payer: Nomi Health Commercial |
$1,844.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.44
|
| Rate for Payer: PHP Commercial |
$1,912.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,957.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.93
|
| Rate for Payer: UHC Core |
$1,878.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.44
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$2,249.92
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.66 |
| Max. Negotiated Rate |
$2,024.93 |
| Rate for Payer: Aetna Commercial |
$1,912.43
|
| Rate for Payer: Aetna Medicare |
$584.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.10
|
| Rate for Payer: BCBS Complete |
$416.46
|
| Rate for Payer: BCBS MAPPO |
$562.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,849.66
|
| Rate for Payer: BCN Commercial |
$1,849.66
|
| Rate for Payer: BCN Medicare Advantage |
$562.48
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cofinity Commercial |
$1,934.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.48
|
| Rate for Payer: Healthscope Commercial |
$2,024.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.44
|
| Rate for Payer: Mclaren Medicaid |
$396.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.60
|
| Rate for Payer: Meridian Medicaid |
$416.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.43
|
| Rate for Payer: Nomi Health Commercial |
$1,844.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.44
|
| Rate for Payer: PACE Senior Care Partners |
$534.36
|
| Rate for Payer: PACE SWMI |
$562.48
|
| Rate for Payer: PHP Commercial |
$1,912.43
|
| Rate for Payer: PHP Medicare Advantage |
$562.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,957.43
|
| Rate for Payer: Priority Health Medicare |
$568.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.94
|
| Rate for Payer: Railroad Medicare Medicare |
$562.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.93
|
| Rate for Payer: UHC Core |
$1,878.68
|
| Rate for Payer: UHC Exchange |
$562.48
|
| Rate for Payer: UHC Medicaid |
$396.66
|
| Rate for Payer: UHC Medicare Advantage |
$562.48
|
| Rate for Payer: UHCCP Medicaid |
$396.66
|
| Rate for Payer: VA VA |
$562.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.44
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
OP
|
$1,367.04
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$241.01 |
| Max. Negotiated Rate |
$1,230.34 |
| Rate for Payer: Aetna Commercial |
$1,161.98
|
| Rate for Payer: Aetna Medicare |
$355.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.20
|
| Rate for Payer: BCBS Complete |
$253.04
|
| Rate for Payer: BCBS MAPPO |
$341.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,123.84
|
| Rate for Payer: BCN Commercial |
$1,123.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.76
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cofinity Commercial |
$1,175.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.76
|
| Rate for Payer: Healthscope Commercial |
$1,230.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.28
|
| Rate for Payer: Mclaren Medicaid |
$241.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.85
|
| Rate for Payer: Meridian Medicaid |
$253.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$375.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,161.98
|
| Rate for Payer: Nomi Health Commercial |
$1,120.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.28
|
| Rate for Payer: PACE Senior Care Partners |
$324.67
|
| Rate for Payer: PACE SWMI |
$341.76
|
| Rate for Payer: PHP Commercial |
$1,161.98
|
| Rate for Payer: PHP Medicare Advantage |
$341.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,189.32
|
| Rate for Payer: Priority Health Medicare |
$345.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$951.46
|
| Rate for Payer: Railroad Medicare Medicare |
$341.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.00
|
| Rate for Payer: UHC Core |
$1,141.48
|
| Rate for Payer: UHC Exchange |
$341.76
|
| Rate for Payer: UHC Medicaid |
$241.01
|
| Rate for Payer: UHC Medicare Advantage |
$341.76
|
| Rate for Payer: UHCCP Medicaid |
$241.01
|
| Rate for Payer: VA VA |
$341.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.28
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
IP
|
$1,367.04
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$951.46 |
| Max. Negotiated Rate |
$1,230.34 |
| Rate for Payer: Aetna Commercial |
$1,161.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,129.04
|
| Rate for Payer: BCN Commercial |
$1,129.04
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cofinity Commercial |
$1,175.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.63
|
| Rate for Payer: Healthscope Commercial |
$1,230.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,161.98
|
| Rate for Payer: Nomi Health Commercial |
$1,120.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.28
|
| Rate for Payer: PHP Commercial |
$1,161.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,189.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$951.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.00
|
| Rate for Payer: UHC Core |
$1,141.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.28
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
IP
|
$1,094.58
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$761.83 |
| Max. Negotiated Rate |
$985.12 |
| Rate for Payer: Aetna Commercial |
$930.39
|
| Rate for Payer: BCBS Trust/PPO |
$904.01
|
| Rate for Payer: BCN Commercial |
$904.01
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cofinity Commercial |
$941.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.66
|
| Rate for Payer: Healthscope Commercial |
$985.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$820.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.39
|
| Rate for Payer: Nomi Health Commercial |
$897.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.93
|
| Rate for Payer: PHP Commercial |
$930.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$952.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$761.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.23
|
| Rate for Payer: UHC Core |
$913.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$820.93
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
OP
|
$1,094.58
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$192.97 |
| Max. Negotiated Rate |
$985.12 |
| Rate for Payer: Aetna Commercial |
$930.39
|
| Rate for Payer: Aetna Medicare |
$284.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.06
|
| Rate for Payer: BCBS Complete |
$202.61
|
| Rate for Payer: BCBS MAPPO |
$273.64
|
| Rate for Payer: BCBS Trust/PPO |
$899.85
|
| Rate for Payer: BCN Commercial |
$899.85
|
| Rate for Payer: BCN Medicare Advantage |
$273.64
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cofinity Commercial |
$941.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.64
|
| Rate for Payer: Healthscope Commercial |
$985.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$820.93
|
| Rate for Payer: Mclaren Medicaid |
$192.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.33
|
| Rate for Payer: Meridian Medicaid |
$202.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$301.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.39
|
| Rate for Payer: Nomi Health Commercial |
$897.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.93
|
| Rate for Payer: PACE Senior Care Partners |
$259.96
|
| Rate for Payer: PACE SWMI |
$273.64
|
| Rate for Payer: PHP Commercial |
$930.39
|
| Rate for Payer: PHP Medicare Advantage |
$273.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$952.28
|
| Rate for Payer: Priority Health Medicare |
$276.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$761.83
|
| Rate for Payer: Railroad Medicare Medicare |
$273.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.23
|
| Rate for Payer: UHC Core |
$913.97
|
| Rate for Payer: UHC Exchange |
$273.64
|
| Rate for Payer: UHC Medicaid |
$192.97
|
| Rate for Payer: UHC Medicare Advantage |
$273.64
|
| Rate for Payer: UHCCP Medicaid |
$192.97
|
| Rate for Payer: VA VA |
$273.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$820.93
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
OP
|
$3,211.46
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$566.18 |
| Max. Negotiated Rate |
$2,890.31 |
| Rate for Payer: Aetna Commercial |
$2,729.74
|
| Rate for Payer: Aetna Medicare |
$834.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.58
|
| Rate for Payer: BCBS Complete |
$594.44
|
| Rate for Payer: BCBS MAPPO |
$802.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.14
|
| Rate for Payer: BCN Commercial |
$2,640.14
|
| Rate for Payer: BCN Medicare Advantage |
$802.87
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cofinity Commercial |
$2,761.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,569.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.87
|
| Rate for Payer: Healthscope Commercial |
$2,890.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,408.59
|
| Rate for Payer: Mclaren Medicaid |
$566.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$843.01
|
| Rate for Payer: Meridian Medicaid |
$594.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,729.74
|
| Rate for Payer: Nomi Health Commercial |
$2,633.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.59
|
| Rate for Payer: PACE Senior Care Partners |
$762.72
|
| Rate for Payer: PACE SWMI |
$802.87
|
| Rate for Payer: PHP Commercial |
$2,729.74
|
| Rate for Payer: PHP Medicare Advantage |
$802.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,793.97
|
| Rate for Payer: Priority Health Medicare |
$810.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,235.18
|
| Rate for Payer: Railroad Medicare Medicare |
$802.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,826.08
|
| Rate for Payer: UHC Core |
$2,681.57
|
| Rate for Payer: UHC Exchange |
$802.87
|
| Rate for Payer: UHC Medicaid |
$566.18
|
| Rate for Payer: UHC Medicare Advantage |
$802.87
|
| Rate for Payer: UHCCP Medicaid |
$566.18
|
| Rate for Payer: VA VA |
$802.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,408.59
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
IP
|
$3,211.46
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,235.18 |
| Max. Negotiated Rate |
$2,890.31 |
| Rate for Payer: Aetna Commercial |
$2,729.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,652.34
|
| Rate for Payer: BCN Commercial |
$2,652.34
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cofinity Commercial |
$2,761.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,569.17
|
| Rate for Payer: Healthscope Commercial |
$2,890.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,408.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,729.74
|
| Rate for Payer: Nomi Health Commercial |
$2,633.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.59
|
| Rate for Payer: PHP Commercial |
$2,729.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,793.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,235.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,826.08
|
| Rate for Payer: UHC Core |
$2,681.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,408.59
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
OP
|
$3,098.73
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$546.31 |
| Max. Negotiated Rate |
$2,788.86 |
| Rate for Payer: Aetna Commercial |
$2,633.92
|
| Rate for Payer: Aetna Medicare |
$805.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$968.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$968.35
|
| Rate for Payer: BCBS Complete |
$573.57
|
| Rate for Payer: BCBS MAPPO |
$774.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,547.47
|
| Rate for Payer: BCN Commercial |
$2,547.47
|
| Rate for Payer: BCN Medicare Advantage |
$774.68
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cofinity Commercial |
$2,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.68
|
| Rate for Payer: Healthscope Commercial |
$2,788.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,324.05
|
| Rate for Payer: Mclaren Medicaid |
$546.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$813.42
|
| Rate for Payer: Meridian Medicaid |
$573.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$852.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.92
|
| Rate for Payer: Nomi Health Commercial |
$2,540.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.05
|
| Rate for Payer: PACE Senior Care Partners |
$735.95
|
| Rate for Payer: PACE SWMI |
$774.68
|
| Rate for Payer: PHP Commercial |
$2,633.92
|
| Rate for Payer: PHP Medicare Advantage |
$774.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,695.90
|
| Rate for Payer: Priority Health Medicare |
$782.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,156.72
|
| Rate for Payer: Railroad Medicare Medicare |
$774.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,726.88
|
| Rate for Payer: UHC Core |
$2,587.44
|
| Rate for Payer: UHC Exchange |
$774.68
|
| Rate for Payer: UHC Medicaid |
$546.31
|
| Rate for Payer: UHC Medicare Advantage |
$774.68
|
| Rate for Payer: UHCCP Medicaid |
$546.31
|
| Rate for Payer: VA VA |
$774.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,324.05
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
IP
|
$3,098.73
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,156.72 |
| Max. Negotiated Rate |
$2,788.86 |
| Rate for Payer: Aetna Commercial |
$2,633.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,559.24
|
| Rate for Payer: BCN Commercial |
$2,559.24
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cofinity Commercial |
$2,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.98
|
| Rate for Payer: Healthscope Commercial |
$2,788.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,324.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.92
|
| Rate for Payer: Nomi Health Commercial |
$2,540.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.05
|
| Rate for Payer: PHP Commercial |
$2,633.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,695.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,156.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,726.88
|
| Rate for Payer: UHC Core |
$2,587.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,324.05
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$5,621.61
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$991.09 |
| Max. Negotiated Rate |
$5,059.45 |
| Rate for Payer: Aetna Commercial |
$4,778.37
|
| Rate for Payer: Aetna Medicare |
$1,461.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,756.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,756.75
|
| Rate for Payer: BCBS Complete |
$1,040.56
|
| Rate for Payer: BCBS MAPPO |
$1,405.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,621.53
|
| Rate for Payer: BCN Commercial |
$4,621.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,405.40
|
| Rate for Payer: Cash Price |
$4,497.29
|
| Rate for Payer: Cofinity Commercial |
$4,834.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,497.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,405.40
|
| Rate for Payer: Healthscope Commercial |
$5,059.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,216.21
|
| Rate for Payer: Mclaren Medicaid |
$991.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,475.67
|
| Rate for Payer: Meridian Medicaid |
$1,040.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,616.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,545.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,778.37
|
| Rate for Payer: Nomi Health Commercial |
$4,609.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,216.21
|
| Rate for Payer: PACE Senior Care Partners |
$1,335.13
|
| Rate for Payer: PACE SWMI |
$1,405.40
|
| Rate for Payer: PHP Commercial |
$4,778.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,405.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,890.80
|
| Rate for Payer: Priority Health Medicare |
$1,419.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,912.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,405.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,947.02
|
| Rate for Payer: UHC Core |
$4,694.04
|
| Rate for Payer: UHC Exchange |
$1,405.40
|
| Rate for Payer: UHC Medicaid |
$991.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,405.40
|
| Rate for Payer: UHCCP Medicaid |
$991.09
|
| Rate for Payer: VA VA |
$1,405.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,216.21
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
IP
|
$5,621.61
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,912.64 |
| Max. Negotiated Rate |
$5,059.45 |
| Rate for Payer: Aetna Commercial |
$4,778.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,642.89
|
| Rate for Payer: BCN Commercial |
$4,642.89
|
| Rate for Payer: Cash Price |
$4,497.29
|
| Rate for Payer: Cofinity Commercial |
$4,834.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,497.29
|
| Rate for Payer: Healthscope Commercial |
$5,059.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,216.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,778.37
|
| Rate for Payer: Nomi Health Commercial |
$4,609.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,216.21
|
| Rate for Payer: PHP Commercial |
$4,778.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,890.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,912.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,947.02
|
| Rate for Payer: UHC Core |
$4,694.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,216.21
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$969.65 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Aetna Commercial |
$4,675.00
|
| Rate for Payer: Aetna Medicare |
$1,430.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,718.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,718.75
|
| Rate for Payer: BCBS Complete |
$1,018.05
|
| Rate for Payer: BCBS MAPPO |
$1,375.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,521.55
|
| Rate for Payer: BCN Commercial |
$4,521.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,375.00
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Commercial |
$4,730.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,375.00
|
| Rate for Payer: Healthscope Commercial |
$4,950.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,125.00
|
| Rate for Payer: Mclaren Medicaid |
$969.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,443.75
|
| Rate for Payer: Meridian Medicaid |
$1,018.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,581.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,512.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Nomi Health Commercial |
$4,510.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,125.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,306.25
|
| Rate for Payer: PACE SWMI |
$1,375.00
|
| Rate for Payer: PHP Commercial |
$4,675.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,375.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$969.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,785.00
|
| Rate for Payer: Priority Health Medicare |
$1,388.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,828.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,375.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,840.00
|
| Rate for Payer: UHC Core |
$4,592.50
|
| Rate for Payer: UHC Exchange |
$1,375.00
|
| Rate for Payer: UHC Medicaid |
$969.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,375.00
|
| Rate for Payer: UHCCP Medicaid |
$969.65
|
| Rate for Payer: VA VA |
$1,375.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,125.00
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,828.00 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Aetna Commercial |
$4,675.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,542.45
|
| Rate for Payer: BCN Commercial |
$4,542.45
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Commercial |
$4,730.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Healthscope Commercial |
$4,950.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Nomi Health Commercial |
$4,510.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,125.00
|
| Rate for Payer: PHP Commercial |
$4,675.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,785.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,828.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,840.00
|
| Rate for Payer: UHC Core |
$4,592.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,125.00
|
|
|
HC INTRACAV APPL - I
|
Facility
|
OP
|
$584.73
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$103.09 |
| Max. Negotiated Rate |
$526.26 |
| Rate for Payer: Aetna Commercial |
$497.02
|
| Rate for Payer: Aetna Medicare |
$152.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.73
|
| Rate for Payer: BCBS Complete |
$108.23
|
| Rate for Payer: BCBS MAPPO |
$146.18
|
| Rate for Payer: BCBS Trust/PPO |
$480.71
|
| Rate for Payer: BCN Commercial |
$480.71
|
| Rate for Payer: BCN Medicare Advantage |
$146.18
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cofinity Commercial |
$502.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.18
|
| Rate for Payer: Healthscope Commercial |
$526.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.55
|
| Rate for Payer: Mclaren Medicaid |
$103.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.49
|
| Rate for Payer: Meridian Medicaid |
$108.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.02
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.55
|
| Rate for Payer: PACE Senior Care Partners |
$138.87
|
| Rate for Payer: PACE SWMI |
$146.18
|
| Rate for Payer: PHP Commercial |
$497.02
|
| Rate for Payer: PHP Medicare Advantage |
$146.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$508.72
|
| Rate for Payer: Priority Health Medicare |
$147.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$406.97
|
| Rate for Payer: Railroad Medicare Medicare |
$146.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.56
|
| Rate for Payer: UHC Core |
$488.25
|
| Rate for Payer: UHC Exchange |
$146.18
|
| Rate for Payer: UHC Medicaid |
$103.09
|
| Rate for Payer: UHC Medicare Advantage |
$146.18
|
| Rate for Payer: UHCCP Medicaid |
$103.09
|
| Rate for Payer: VA VA |
$146.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.55
|
|
|
HC INTRACAV APPL - I
|
Facility
|
IP
|
$584.73
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$406.97 |
| Max. Negotiated Rate |
$526.26 |
| Rate for Payer: Aetna Commercial |
$497.02
|
| Rate for Payer: BCBS Trust/PPO |
$482.93
|
| Rate for Payer: BCN Commercial |
$482.93
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cofinity Commercial |
$502.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.78
|
| Rate for Payer: Healthscope Commercial |
$526.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.02
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.55
|
| Rate for Payer: PHP Commercial |
$497.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$508.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$406.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.56
|
| Rate for Payer: UHC Core |
$488.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.55
|
|
|
HC INTRACAV APPL - S
|
Facility
|
IP
|
$445.71
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$310.21 |
| Max. Negotiated Rate |
$401.14 |
| Rate for Payer: Aetna Commercial |
$378.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.11
|
| Rate for Payer: BCN Commercial |
$368.11
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cofinity Commercial |
$383.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Healthscope Commercial |
$401.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Nomi Health Commercial |
$365.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: PHP Commercial |
$378.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$387.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.22
|
| Rate for Payer: UHC Core |
$372.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.28
|
|
|
HC INTRACAV APPL - S
|
Facility
|
OP
|
$445.71
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$78.58 |
| Max. Negotiated Rate |
$401.14 |
| Rate for Payer: Aetna Commercial |
$378.85
|
| Rate for Payer: Aetna Medicare |
$115.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.28
|
| Rate for Payer: BCBS Complete |
$82.50
|
| Rate for Payer: BCBS MAPPO |
$111.43
|
| Rate for Payer: BCBS Trust/PPO |
$366.42
|
| Rate for Payer: BCN Commercial |
$366.42
|
| Rate for Payer: BCN Medicare Advantage |
$111.43
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cofinity Commercial |
$383.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.43
|
| Rate for Payer: Healthscope Commercial |
$401.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.28
|
| Rate for Payer: Mclaren Medicaid |
$78.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.00
|
| Rate for Payer: Meridian Medicaid |
$82.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Nomi Health Commercial |
$365.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: PACE Senior Care Partners |
$105.86
|
| Rate for Payer: PACE SWMI |
$111.43
|
| Rate for Payer: PHP Commercial |
$378.85
|
| Rate for Payer: PHP Medicare Advantage |
$111.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$387.77
|
| Rate for Payer: Priority Health Medicare |
$112.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.21
|
| Rate for Payer: Railroad Medicare Medicare |
$111.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.22
|
| Rate for Payer: UHC Core |
$372.17
|
| Rate for Payer: UHC Exchange |
$111.43
|
| Rate for Payer: UHC Medicaid |
$78.58
|
| Rate for Payer: UHC Medicare Advantage |
$111.43
|
| Rate for Payer: UHCCP Medicaid |
$78.58
|
| Rate for Payer: VA VA |
$111.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.28
|
|
